IADR Abstract Archives
Relative Risk of Clinical Characteristics Associated With Post-Treatment TMD Pain
Objectives: Baseline characteristics can be used to predict occurrence of clinically significant temporomandibular (TMD) pain post-treatment.
Methods: In this prospective cohort study, TMD pain patients (n=1901) sought treatment for their TMD pain in 182 dental practices enrolled in the National Dental Practice-Based Research Network (NationalDentalPBRN.org). Relative risk (RR) was used to estimate association of Characteristic Pain Index (CPI) scores ≥ 60/100 at 6-month follow-up. GEE logistic regression accounted for clustering of patients within Network practices. The median value served as the cutoff for high versus low (=reference) categories of continuous predictors. Discrete categorical predictors were assessed as 1=present versus 0=absent. The control category for ordinal predictors was their least severe category.
Results: Compared to their reference groups, the RR estimates for the following categories of eight baseline characteristics were significantly associated (P<0.0024) with CPI scores ≥ 60/100 at 6-month follow-up:
1. Graded Chronic Pain Scale: Grades 2-4 versus Grade 1 (reference) (RR ranges = 4.87-13.57).
2. CPI >50/100 versus ≤ 50/100 (RR = 5.32).
3. Difficulty Coping with Psychological Distress (Patient Health Questionnaire - 4): ‘Somewhat difficult’=1 versus None=0; ‘Very difficult’=2 versus 0; ‘Extremely difficult’= 3 versus 0 (RR ranges = 1.85 - 3.52).
4. Widespread Pain (WSP): > 6/21 sites versus ≤ 6/21 sites (RR = 2.37).
5. WSP present ≥ 3 months versus < 3 months (RR = 3.52).
6. >1 prior TMD pain clinicians versus 0-1 clinician (RR = 2.13).
7. Modified Oral Behavioral Checklist: > 0.73 versus ≤ 0.73) (RR = 1.70).
8. TMD pain ≥ 3 years versus < 3 years (RR = 1.59).
Conclusions: Relative Risk estimates for higher categories of eight baseline characteristics can be associated with significantly higher chance of having persistent, moderate to severe pain intensity at 6-month follow-up. This information may assist in selection of treatment strategies.
Methods: In this prospective cohort study, TMD pain patients (n=1901) sought treatment for their TMD pain in 182 dental practices enrolled in the National Dental Practice-Based Research Network (NationalDentalPBRN.org). Relative risk (RR) was used to estimate association of Characteristic Pain Index (CPI) scores ≥ 60/100 at 6-month follow-up. GEE logistic regression accounted for clustering of patients within Network practices. The median value served as the cutoff for high versus low (=reference) categories of continuous predictors. Discrete categorical predictors were assessed as 1=present versus 0=absent. The control category for ordinal predictors was their least severe category.
Results: Compared to their reference groups, the RR estimates for the following categories of eight baseline characteristics were significantly associated (P<0.0024) with CPI scores ≥ 60/100 at 6-month follow-up:
1. Graded Chronic Pain Scale: Grades 2-4 versus Grade 1 (reference) (RR ranges = 4.87-13.57).
2. CPI >50/100 versus ≤ 50/100 (RR = 5.32).
3. Difficulty Coping with Psychological Distress (Patient Health Questionnaire - 4): ‘Somewhat difficult’=1 versus None=0; ‘Very difficult’=2 versus 0; ‘Extremely difficult’= 3 versus 0 (RR ranges = 1.85 - 3.52).
4. Widespread Pain (WSP): > 6/21 sites versus ≤ 6/21 sites (RR = 2.37).
5. WSP present ≥ 3 months versus < 3 months (RR = 3.52).
6. >1 prior TMD pain clinicians versus 0-1 clinician (RR = 2.13).
7. Modified Oral Behavioral Checklist: > 0.73 versus ≤ 0.73) (RR = 1.70).
8. TMD pain ≥ 3 years versus < 3 years (RR = 1.59).
Conclusions: Relative Risk estimates for higher categories of eight baseline characteristics can be associated with significantly higher chance of having persistent, moderate to severe pain intensity at 6-month follow-up. This information may assist in selection of treatment strategies.